255 Scaling Up Housing First in Europe Maša Filipovič Hrast Faculty of Social Sciences, University of Ljubljana, Slovenia Introduction Housing First (HF) represents a new approach in helping homeless people, which was developed in the USA and has in recent years been increasingly adopted in European countries. The adoption of this approach has been questioned on the basis of its transferability to different cultural, economic and welfare contexts and the need for fidelity to the originally developed concept. However, it has already been argued that HF represents a range of services that all follow the same operational principles (e.g., Pleace and Bretherton, 2013). It has also been argued that the typology of HF is constructed for adaptability, and consequently transferability into different contexts. The 2014 article by Busch-Geertsema, Results of a European Social Experimentation Project, further strengthens these arguments. It clearly presents the argument that it is not only possible to transfer the HF model to a variety of different cultural, economic and welfare contexts within the EU, but that such transfers are also highly successful. The author of the article states that data confirmed a number of studies in the US and elsewhere that the Housing First approach facilitates high rates of housing retention, and that it is possible to house homeless persons even with the most complex support needs in independent, scattered housing (2014, p.20). It also indicates that for the success of HF, high fidelity to the model is not needed but, rather, following the core principles seems to be sufficient to ensure a high rate of success with the model. As Pleace and Bretherton (2013, p.34) suggest, lowerand higher-cost variants of HF can be developed to reflect available resources, allowing for a wide-ranging use of the approach in the EU. High fidelity to the original approach might, perhaps, not even be desirable in the EU context, as adaption to specific circumstances is most likely vital for the success of projects in different locations and contexts. As Busch-Geertsema emphasized in his article, the ability to ensure housing for homeless people depends on the specific housing contexts of individual countries (e.g., whether the social rental sector or the private ISSN 2030-2762 / ISSN 2030-3106 online
256 European Journal of Homelessness _ Volume 8, No. 2, December 2014 rental sector is used), and the level of housing support needed depends on how health and other services are organised within individual welfare systems. According to the results of the HFE project described in Busch-Geertsema s article, there is strong evidence of the transferability and success of the model in Europe. However, in this response I would like to elaborate on an issue that the author of the article raised in the concluding section, and that is the question of scaling up the HF model. As the author emphasizes: It remains to be seen to what extent these plans [of implementing the approach on a wider scale] go beyond single projects for a very strictly defined target group (2014, p.24). Scaling up HF Scaling up can be approached in two ways. The first is scaling up by widening the HF target group. The second is scaling up in terms of a wider policy adoption of the model, moving from a mere experimental or specific local project to a wider national policy level. Regarding the applicability of the HF approach to a variety of vulnerable groups, current use of HF in Europe and elsewhere already seems to indicate a positive answer on the possibilities of scaling up the model. The HF cases included in the HFE project indicate its applicability to a variety of groups with different needs of a more or less complex nature, such as alcohol abuse, drug abuse, mental health issues or combinations of these. As Busch-Geertsema (2013, p.325) described it: There is no reason why other homeless people with less severe support needs should have to endure preparatory periods of several years before they are re-housed, if the necessary support can just as easily and much more effectively be provided in regular permanent housing. Scaling up can also mean widening this approach from a local and in some cases experimental project to a wider national policy. At the moment, HF initiatives are mainly part of very small-scale local or experimental projects. Busch-Geertsema mentions in his article that in some countries there are plans to implement the approach on a wider scale, and the Copenhagen test site (part of the HFE project) was part of a nation-wide strategy. However, the number of countries where there is even the potential of HF application on a larger scale and within a national policy still seems to be rather limited. Similar difficulties seem to apply both to scaling up in terms of widening the group and to scaling-up in terms of inclusion in regular (welfare) policy approaches; both are linked to questions of how successful the approach is and its financial sustainability. In times of financial and economic crises and retrenchment of the welfare state, the expansion of welfare programmes is not favoured by governments. Perhaps even more importantly, it is questionable if it would even be favoured by
257 the people, as it would invoke issues of welfare state dependency and the issue of deserving/undeserving that relates to all welfare spending. In light of this, perhaps the best way to promote such initiatives is by stressing how they relate to wider issues, such as the role of housing in welfare provision, housing rights and the role of users in service provision. First, HF opens up debates on the role of housing in welfare states. HF initiatives can potentially illustrate how housing is a vital part of securing welfare and that housing should be the cornerstone of the welfare state and not the wobbly pillar (see Torgersen, 1987; Malpass, 2008). This might be especially relevant in the CEE countries, where privatisation of large shares of the housing stock, the dominance of home-ownership, and poor regulation of private rental markets and small social rental markets not only make access to housing highly problematic for the most vulnerable groups in society (such as homeless people with high support needs as are targeted by HF), but they also relate to a wider segment of the population that is suffering from housing exclusion. Secondly, HF puts forward more strongly the idea of housing as a basic human right and as part of citizenship rights (as defined by Marshall). The right to housing is embedded in several international documents, including the 1948 Universal Declaration of Human Rights, the 1966 International covenant on Economic, Social and Cultural Rights, the European Social Charter, the EU Charter of Fundamental Rights and the 1996 Habitat Agenda; these documents emphasise the importance of security of tenure, as well as the affordability, habitability, accessibility, location and cultural adequacy of housing. HF ensures the most direct protection of these rights when compared to more indirect protection through prevention, enabling policies and approaches, legal frameworks, and so on. Thirdly, HF, in its main principles, emphasises giving voice and choice to (welfare) service users, and therefore supports the approaches in literature that emphasize empowerment of service users and their inclusion in decision-making as central concepts. Service users have, to a large degree, become co-producers of services, though to what extent also depends on the welfare state regime (Pestoff, 2009), and the most vulnerable have been, perhaps to a lesser degree, part of this development. Consequently, HF emphasises that these approaches need to be implemented for all.
258 European Journal of Homelessness _ Volume 8, No. 2, December 2014 Conclusion HF is a model that addresses the social problem of homelessness in an alternative way. It therefore requires policy change, which is, of course, difficult even in the best of circumstances due to issues of path dependency, existing institutional frameworks and existing ideology. In times of economic crisis, the question of cost might be an additional strong argument against policy change. However showing cost effectiveness of HF approaches could address these arguments. As HF models can differ significantly, comparing models and their success, as well as cost effectiveness in different contexts, poses a challenge. Further research would be needed, taking into account all relevant contextual factors along with differences among the models. Despite the difficulty such an endeavour poses, this might be important way of broadening support for such initiatives.
259 > > References Busch-Geertsema (2013) Swimming Can Better be Learned in the Water Than Anywhere Else, European Journal of Homelessness 7(2) pp.323-326. Busch-Geertsema (2014) Results of a European Social Experimentation Project, European Journal of Homelessness 8(1) pp.13-28. Malpass P. (2008) Housing and the New Welfare State: Wobbly Pillar or Cornerstone, Housing Studies 23(1) pp1-19. Marshall, T. H. (1950) Citizenship and Social Class, and Other Essays (Cambridge: Cambridge University Press). Pestoff, V. (2009) A Democratic Architecture for the Welfare State (London / New York: Routledge). Pleace, N. and Bretherton J. (2013) The Case for Housing First in the European Union: A Critical Evaluation of Concerns about Effectiveness, European Journal of Homelessness 7(2) pp.21-42. Torgersen U. (1987) Housing: The Wobbly Pillar under the Welfare State, Scandinavian Journal of Housing and Planning Research Supplement 4(1) pp.116-127.